1
|
Tetzlaff EJ, Cassan C, Goulet N, Gorman M, Hogya B, Kenny GP. "Breaking down in tears, soaked in sweat, and sick from the heat": Media-based composite narratives of first responders working during the 2021 Heat Dome. Am J Ind Med 2024; 67:442-452. [PMID: 38460501 DOI: 10.1002/ajim.23576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 01/15/2024] [Accepted: 02/19/2024] [Indexed: 03/11/2024]
Abstract
BACKGROUND During the summer of 2021, a deadly, unprecedented multiday Heat Dome engulfed western Canada. As a result of this extreme heat event (EHE), emergency dispatchers received an unparalleled increase in incoming 911 calls for ambulance, police, and fire (as first responders) services to attend to hundreds of heat-vulnerable community members succumbing to the heat. With 103 all-time heat records broken during this EHE and indoor temperatures of nearly 40°C, the first responders attending these calls faced extensive job demands and highly challenging operating conditions. Initial investigations have explored the health system-level impacts; however, little has been done to explore the impact on the first responders themselves. Therefore, this study aimed to improve our understanding of EHEs' impacts on the operational capabilities and health of first responders, specifically police, fire, ambulance, and dispatch services. METHODS A systematized review and content analysis of media articles published on the 2021 Heat Dome in Canada was conducted (n = 2909), and four media-based composite narratives were developed highlighting police, fire, ambulance, and dispatch services. The Job Demands-Resources (JD-R) model was applied as a theoretical framework for occupational burnout. RESULTS The media-based composite narratives highlighted that first responders faced record-breaking call volumes, increased mental-health-related claims, and exhaustive heat-related physiological stress. Using the JD-R model as a theoretical framework for occupational burnout, we identified three measures of stressful job demand: work overload (e.g., the surge in call volume, firefighters responding to medical emergencies), emotional demands (e.g., severe medical emergencies, sudden deaths, unresponsive patients, distraught family members), and physical demands (e.g., resuscitation in personal protective equipment, heat-related illness). CONCLUSION The experiences described underscore the importance of supporting first responders during work in extreme heat conditions. These findings have important implications for addressing rising rates of burnout during and following public health crises, such as EHEs, a problem that is increasingly being recognized as a threat to the Canadian public healthcare system.
Collapse
Affiliation(s)
- Emily J Tetzlaff
- Human and Environmental Physiology Research Unit, School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
- Heat Division, Climate Change and Innovation Bureau, Healthy Environments and Consumer Safety Branch, Safe Environments Directorate, Health Canada, Ottawa, Ontario, Canada
| | - Casey Cassan
- Human and Environmental Physiology Research Unit, School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Nicholas Goulet
- Human and Environmental Physiology Research Unit, School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
- Heat Division, Climate Change and Innovation Bureau, Healthy Environments and Consumer Safety Branch, Safe Environments Directorate, Health Canada, Ottawa, Ontario, Canada
| | - Melissa Gorman
- Heat Division, Climate Change and Innovation Bureau, Healthy Environments and Consumer Safety Branch, Safe Environments Directorate, Health Canada, Ottawa, Ontario, Canada
| | - Brooks Hogya
- BC Emergency Health Services, Provincial Health Services Authority, Vancouver, British Columbia, Canada
| | - Glen P Kenny
- Human and Environmental Physiology Research Unit, School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| |
Collapse
|
2
|
Adamovic N, Howes LM, White R, Julian R. Understanding the challenges of disaster victim identification: perspectives of Australian forensic practitioners. Forensic Sci Res 2023; 8:107-115. [PMID: 37621448 PMCID: PMC10445580 DOI: 10.1093/fsr/owad020] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 04/28/2023] [Indexed: 08/26/2023] Open
Abstract
Disaster victim identification (DVI) is an important process in the aftermath of disasters to provide answers for the families and communities of victims. Australian forensic practitioners contribute to such processes internationally under difficult post-disaster circumstances. The aim of the study was to better understand the challenges experienced by forensic practitioners in international DVI operations. Participants (N = 20) included DNA analysts, fingerprint examiners, forensic odontologists, forensic pathologists, and mortuary technicians who had experience in DVI operations. Participants were interviewed about their experiences and perceptions of the challenges of DVI. The findings provide valuable insights into the types of DVI operations in which Australian forensic practitioners have been involved internationally. Thematic analysis of interview data resulted in five main themes: the post-disaster work environment; DVI management and processes; political and financial influences; teamwork in intercultural and interdisciplinary contexts; and confronting the emotional realities of DVI work. The analysis highlights the interrelated challenges associated with DVI operations in international contexts. Practitioners also provided suggestions for improvement, which generally aligned with the themes and reflected an ethos of learning and continuous improvement in DVI. Further research on education and training and capacity-development initiatives is warranted.
Collapse
Affiliation(s)
- Natasa Adamovic
- School of Social Sciences, College of Arts, Law and Education and Tasmanian Institute of Law Enforcement Studies (TILES), University of Tasmania, Hobart, Australia
| | - Loene M Howes
- School of Social Sciences, College of Arts, Law and Education and Tasmanian Institute of Law Enforcement Studies (TILES), University of Tasmania, Hobart, Australia
| | - Rob White
- School of Social Sciences, College of Arts, Law and Education and Tasmanian Institute of Law Enforcement Studies (TILES), University of Tasmania, Hobart, Australia
| | - Roberta Julian
- School of Social Sciences, College of Arts, Law and Education and Tasmanian Institute of Law Enforcement Studies (TILES), University of Tasmania, Hobart, Australia
| |
Collapse
|
3
|
Physical and psychological challenges faced by military, medical and public safety personnel relief workers supporting natural disaster operations: a systematic review. CURRENT PSYCHOLOGY 2023. [DOI: 10.1007/s12144-023-04368-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
Abstract
AbstractNatural disasters, including floods, earthquakes, and hurricanes, result in devastating consequences at the individual and community levels. To date, much of the research reflecting the consequences of natural disasters focuses heavily on victims, with little attention paid to the personnel responding to such disasters. We conducted a systematic review of the challenges faced by military, medical and public safety personnel supporting natural disaster relief operations. Specifically, we report on the current evidence reflecting challenges faced, as well as positive outcomes experienced by military, medical and public safety personnel following deployment to natural disasters. The review included 382 studies. A large proportion of the studies documented experiences of medical workers, followed by volunteers from humanitarian organizations and military personnel. The most frequently reported challenges across the studies were structural (i.e., interactions with the infrastructure or structural institutions), followed by resource limitations, psychological, physical, and social challenges. Over 60% of the articles reviewed documented positive or transformative outcomes following engagement in relief work (e.g., the provision of additional resources, support, and training), as well as self-growth and fulfillment. The current results emphasize the importance of pre-deployment training to better prepare relief workers to manage expected challenges, as well as post-deployment supportive services to mitigate adverse outcomes and support relief workers’ well-being.
Collapse
|
4
|
North CS, McDonald K. A Prospective Post-disaster Longitudinal Follow-up Study of Emotional and Psychosocial Outcomes of the Oklahoma City Bombing Rescue and Recovery Workers During the First Quarter Century Afterward. Disaster Med Public Health Prep 2023; 17:e331. [PMID: 36815364 DOI: 10.1017/dmp.2022.296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Abstract
OBJECTIVE Little prospectively assessed post-disaster longitudinal research has been done on mental health (MH) outcomes of disaster rescue and recovery workers. This longitudinal prospective study, which is examining first responders to a terrorist bombing in Oklahoma City after nearly a quarter century, was conducted to investigate their long-term MH outcomes using full diagnostic assessments. This will most accurately inform planning for longitudinal MH care needs. METHODS Longitudinal follow-up interviews of 124 rescue and recovery workers, from an original volunteer sample of 181 volunteer workers, were completed 3 years after the bombing, and reassessed 23 years after using consistent research methods. Structured diagnostic interviews were conducted at both assessments, but these were limited to posttraumatic stress disorder (PTSD) and major depressive disorder (MDD) with additional questions about alcohol use, problems, and major psychosocial problems of life at follow up. RESULTS Initially, the rescue and recovery workers had a lower prevalence of post-disaster PTSD and MDD than directly exposed survivors. They also showed higher rates of PTSD than MDD. However, over time, PTSD increased a little while MDD increased 4-fold though fewer than 50% of the cases were remitted. CONCLUSION Low remission and increasing MDD provide incentives for surveillance and availability of treatment for decades after disaster, regardless of whether they were pre-existing conditions or disaster related.
Collapse
Affiliation(s)
- Carol S North
- The Altshuler Center for Education and Research, Metrocare Services, Dallas, Texas, USA
- The Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Katy McDonald
- The Altshuler Center for Education and Research, Metrocare Services, Dallas, Texas, USA
| |
Collapse
|
5
|
From stress to stigma - Mental health considerations of health care workers involved in COVID19 management. Indian J Tuberc 2022; 69:590-595. [PMID: 36460394 PMCID: PMC8474795 DOI: 10.1016/j.ijtb.2021.09.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 08/16/2021] [Accepted: 09/16/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND Healthcare workers (HCWs) involved in administration and patient management during COVID-19 pandemic are at high risk of developing psychological problems related to fear and stress of contacting COVID infection. This is augmented by the stigma faced at home and society, owing to the nature of their job. AIM To assess the mental health issues and stigma amongst health care workers involved in COVID care. METHODOLOGY We conducted a hospital based cross sectional study where 150 health care workers involved in the care of COVID-19 patients, directly and indirectly, were selected using systematic random sampling. They were assessed using Depression, Anxiety and Stress Scale (DASS-21) Hindi Version, The Impact of Event Scale - Revised scale and a Modified Stigma scale. RESULTS Significant psychological stress, anxiety, depression and high risk for developing post-traumatic stress disorder was found in more than half of the healthcare workers, albeit more in those having direct contact with COVID patients (p < 0.05). Stigma was significantly reported in most HCWs, especially with concerns regarding public attitude and disclosure of their work profile. CONCLUSION Healthcare Workers are at a higher risk for developing psychological disorders and post-traumatic stress disorder because of the immensely stressful work-related conditions and stigma related to working with COVID patients. This may lead to long lasting psychosocial consequences which may affect more severely than the infection itself. Early identification of psychological issues of HCWs and timely intervention is the key.
Collapse
|
6
|
Josam I, Grothe S, Lüdecke D, Vonneilich N, von dem Knesebeck O. Burdening and Protective Organisational Factors among International Volunteers in Greek Refugee Camps—A Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148599. [PMID: 35886458 PMCID: PMC9324479 DOI: 10.3390/ijerph19148599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 06/28/2022] [Accepted: 07/12/2022] [Indexed: 11/16/2022]
Abstract
A majority of the workforce in the humanitarian aid consists of volunteers who partly suffer from health problems related to their voluntary service. To date, only a fraction of the current research focuses on this population. The aim of this qualitative explorative study was to identify burdening and protective organisational factors for health and well-being among humanitarian aid volunteers in a Greek refugee camp. To this end, interviews with 22 volunteers were held on site and afterwards analysed by using qualitative content analysis. We focused on international volunteers working in Greece that worked in the provision of food, material goods, emotional support and recreational opportunities. We identified burdening factors, as well as protective factors, in the areas of work procedures, team interactions, organisational support and living arrangements. Gender-specific disadvantages contribute to burdening factors, while joyful experiences are only addressed as protective factors. Additionally, gender-specific aspects in the experience of team interactions and support systems were identified. According to our findings, several possibilities for organisations to protect health and well-being of their volunteers exist. Organisations could adapt organisational structures to the needs of their volunteers and consider gender-specific factors.
Collapse
|
7
|
Modulating Elements of Nurse Resilience in Population Care during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19084452. [PMID: 35457319 PMCID: PMC9029380 DOI: 10.3390/ijerph19084452] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 04/04/2022] [Accepted: 04/05/2022] [Indexed: 01/08/2023]
Abstract
COVID-19 has significantly affected the work environment of nurses. In the face of the challenges posed by stressors in clinical practice, some nurses adapt and prove to be resilient. In the face of the COVID-19 pandemic, the nature of care itself and the new ways of working are potentially very stressful. We aim to analyze the resilience of care nurses to the psychological impact of the COVID-19 pandemic. This study is a systematic review of nurse caregiver resilience to the COVID-19 pandemic in 2021. Our search was conducted in the WOS, Medline/PubMed, Cochrane, BVS/LILACS, and Cuiden databases. The inclusion criteria were: studies published in Spanish or English; carried out from March 2020 to May 2021 on nurses caring for patients with COVID-19; and investigating the factors influencing the psychological impact, resilience, strategies to develop it, and interventions to promote it during this pandemic and others, such as SARS, MERS, or ebola. The quality of the studies and the risk of bias were evaluated following ICROMS, STROBE and AMSTAR-2 criteria. Twenty-two studies were selected. Most of the studies highlighted the presence of stressors in nurses, emphasizing those of the environment, which converged in dysfunctional responses that hurt their resilience. The most persuasive factors were social and organizational support. Coping strategies developed by nurses and especially interventions by organizations were detected as instruments to foster resilience, but have not been well researched. Resilience has a key moderating role in mitigating the psychological impact of nurses in the face of the COVID-19 pandemic.
Collapse
|
8
|
Chimed-Ochir O, Yumiya Y, Taji A, Kishita E, Kondo H, Wakai A, Akahoshi K, Chishima K, Toyokuni Y, Koido Y, Kubo T. Emergency Medical Teams' Responses during the West Japan Heavy Rain 2018: J-SPEED Data Analysis. Prehosp Disaster Med 2022; 37:1-7. [PMID: 35225205 PMCID: PMC8958047 DOI: 10.1017/s1049023x22000231] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 11/19/2021] [Accepted: 12/04/2021] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Rainfall-induced floods and landslides accounted for 20.7% of all disaster events in Japan from 1985 through 2018 and caused a variety of health problems, both directly and indirectly, including injuries, infectious diseases, exacerbation of pre-existing medical conditions, and psychological issues. More evidence of health problems caused by floods or heavy rain is needed to improve preparedness and preventive measures; however, collecting health data surrounding disaster events is a major challenge due to environmental hazards, logistical constraints, political and economic issues, difficulties in communication among stakeholders, and cultural barriers. In response to the West Japan Heavy Rain in July 2018, Emergency Medical Teams (EMTs) used Japan - Surveillance in Post-Extreme Emergencies and Disasters (J-SPEED) as a daily reporting template, collecting data on the number and type of patients they treated and sending it to an EMT coordination cell (EMTCC) during the response. STUDY OBJECTIVE The aim of the study was to conduct a descriptive epidemiology study using J-SPEED data to better understand the health problems during floods and heavy rain disasters. METHODS The number and types of health problems treated by EMTs in accordance with the J-SPEED (Ver 1.0) form were reported daily by 85 EMTs to an EMTCC, where data were compiled during the West Japan Heavy Rain from July 8 through September 11, 2018. Reported items in the J-SPEED form were analyzed by age, gender, area (prefecture), and time period. RESULTS The analysis of J-SPEED data from the West Japan Heavy Rain 2018 revealed the characteristics of a total of 3,617 consultations with the highest number of consultations (2,579; 71.3%) occurring between Day 5 and Day 12 of the 65-day EMT response. During the response period, skin disease was the most frequently reported health event (17.3%), followed by wounds (14.3%), disaster stress-related symptoms (10.0%), conjunctivitis (6.3%), and acute respiratory infections (ARI; 5.4%). CONCLUSION During the response period, skin disease was the most frequently reported health event, followed by wounds, stress, conjunctivitis, and ARIs. The health impacts of a natural disaster are determined by a variety of factors, and the current study's findings are highly context dependent; however, it is expected that as more data are gathered, the consistency of finding will increase.
Collapse
Affiliation(s)
- Odgerel Chimed-Ochir
- Department of Public Health and Health Policy, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Yui Yumiya
- Department of Public Health and Health Policy, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Akihiro Taji
- Department of Public Health and Health Policy, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Eisaku Kishita
- Hiroshima Prefectural Health and Welfare Bureau, Hiroshima, Japan
| | - Hisayoshi Kondo
- National Hospital Organization Headquarters DMAT Secretariat MHLW Japan, Tokyo, Japan
| | - Akinori Wakai
- National Hospital Organization Headquarters DMAT Secretariat MHLW Japan, Osaka City, Japan
| | - Kouki Akahoshi
- National Hospital Organization Headquarters DMAT Secretariat MHLW Japan, Tokyo, Japan
| | - Kayoko Chishima
- National Hospital Organization Headquarters DMAT Secretariat MHLW Japan, Tokyo, Japan
| | - Yoshiki Toyokuni
- National Hospital Organization Headquarters DMAT Secretariat MHLW Japan, Tokyo, Japan
| | - Yuichi Koido
- National Hospital Organization Headquarters DMAT Secretariat MHLW Japan, Tokyo, Japan
| | - Tatsuhiko Kubo
- Department of Public Health and Health Policy, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| |
Collapse
|
9
|
Carmassi C, Dell'Oste V, Bui E, Foghi C, Bertelloni CA, Atti AR, Buselli R, Di Paolo M, Goracci A, Malacarne P, Nanni MG, Gesi C, Cerveri G, Dell'Osso L. The interplay between acute post-traumatic stress, depressive and anxiety symptoms on healthcare workers functioning during the COVID-19 emergency: A multicenter study comparing regions with increasing pandemic incidence. J Affect Disord 2022; 298:209-216. [PMID: 34728285 PMCID: PMC8556686 DOI: 10.1016/j.jad.2021.10.128] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 07/30/2021] [Accepted: 10/20/2021] [Indexed: 12/21/2022]
Abstract
BACKGROUND Healthcare workers (HCWs) deployed to the frontline during the COVID-19 pandemic are at risk for developing mental disorders, with a possible impact on their wellbeing and functioning. The present study aimed at investigating post-traumatic stress symptoms (PTSS), anxiety and depressive symptoms and their relationships with impairment in the functioning impairment among frontline HCWs from three Italian regions differently exposed to the first wave of the COVID-19 emergency: Tuscany (low), Emilia-Romagna (medium) and Lombardy (high). METHODS 514 frontline HCWs were consecutively enrolled in hospital units devoted to the treatment of COVID-19 patients. They completed the IES-R, PHQ-9 and GAD-7 to assess PTSS, depressive and anxiety symptoms respectively, and the WSAS to investigate functioning impairment. RESULTS A total of 23.5% of HCWs reported severe PTSS, 22.4% moderate-severe anxiety symptoms, 19.3% moderate-severe depressive symptoms and 22.8% impairment in global functioning. HCWs from the higher-exposure regions reported significantly higher scores in all instruments than those from lower-exposure regions. In a multiple linear regression model, PTSS, depressive and anxiety symptoms presented a significant positive association with the functioning impairment. Both PTSS and depression resulted to be independently related to functioning impairment. LIMITATIONS The cross-sectional design and the use of self-report instruments. CONCLUSIONS Depressive and PTSS appear to be the greatest contributors to functioning impairment in HCWs exposed to a massive stressful sanitary event as the COVID-19 pandemic. A more accurate assessment of work-related mental health outcomes in such population could help planning effective prevention strategies and therapeutic interventions.
Collapse
Affiliation(s)
- Claudia Carmassi
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Valerio Dell'Oste
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy; Department of Biotechnology, Chemistry and Pharmacy, University of Siena, Siena, Italy.
| | - Eric Bui
- Department of Psychiatry, Caen University and Caen University Hospital, Caen, France
| | - Claudia Foghi
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | | | - Anna Rita Atti
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Rodolfo Buselli
- Occupational Health Department, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | - Marco Di Paolo
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy
| | - Arianna Goracci
- Department of Molecular and Developmental medicine, University of Siena, Siena, Italy
| | - Paolo Malacarne
- Anaesthesia and Intensive Care Unit, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | - Maria Giulia Nanni
- Department of Neurosciences and Rehabilitation, University of Ferrara, Ferrara, Italy
| | - Camilla Gesi
- Department of Mental Health and Addiction, ASST Fatebenefratelli-Sacco, Milan, Italy
| | | | - Liliana Dell'Osso
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| |
Collapse
|
10
|
Cockcroft-McKay C, Eiroa-Orosa FJ. Barriers to accessing psychosocial support for humanitarian aid workers: a mixed methods inquiry. DISASTERS 2021; 45:762-796. [PMID: 32557869 DOI: 10.1111/disa.12449] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
International and national humanitarian aid workers were recruited for this study via purposive sampling techniques using social media. Eight interviews and one focus group discussion were carried out (n=13), and a survey disseminated (n=62), to garner a broad range of perspectives on barriers to aid workers seeking out and accessing psychosocial support. A thematic analysis was performed on the transcriptions of the interviews and focus group discussion. The hypothesis was that participants would describe a variety of personal, professional, and environmental obstacles, with 'tough-guy macho culture' and/or 'martyr culture' being the strongest deterrents. Fourteen barriers in total were identified: accessibility; appropriateness; attitude; availability; confidentiality and trust; duty of care; guidance; normalisation; experience; repercussions; self-awareness; self-reliance; stigma; and time. It is recommended that organisations improve the provision of quality, appropriate psychosocial support for staff, and that it is communicated regularly, and they train staff in pinpointing when others are in need of assistance.
Collapse
Affiliation(s)
- Caitlin Cockcroft-McKay
- Independent Mental Health and Psychosocial Support Consultant and MSc Postgraduate, International Humanitarian Psychosocial Intervention, School of Psychology, University of East London, United Kingdom
| | - Francisco José Eiroa-Orosa
- Ramón y Cajal Researcher, Section of Personality, Evaluation and Psychological Treatment, Department of Clinical Psychology and Psychobiology, University of Barcelona, Spain
| |
Collapse
|
11
|
Wang X, Li X, Qi M, Hu X, Zhu H, Shi X. Incidence of post-traumatic stress disorder in survivors of traumatic fracture: a systematic review and meta-analysis. PSYCHOL HEALTH MED 2021; 27:902-916. [PMID: 34313497 DOI: 10.1080/13548506.2021.1957953] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Post-traumatic stress disorder (PTSD) is prevalent in traumatic events. It is a great hazard of physical and mental health due to their severity and frequency. Traumatic fractures are one of the major causes of PTSD. The incidence of traumatic fractures has been high in recent years, which will directly or indirectly result in PTSD. Our target is to estimate the pooled incidence of PTSD in fracture patients after traumatic events and to explore possible influencing factors by a meta-analysis.The systematic searches in the electronic bibliographic databases of Web of Science, ScienceDirect, Ovid MEDLINE, PubMed, CNKI (China National Knowledge Infrastructure), Wangfang , and Veipu Databases. Not only were heterogeneity and 95% confidence interval (CI) used for comprehensive assessing each pooled, but also was the P value. Subgroup analyses for some sample characteristics were calculated the pooled incidence of PTSD among patients suffered from fractures.In total, 2619 patients suffered from fracture, and were assessed PTSD in the 12 eligible studies. The heterogeneity was not low (I2 = 97.6%, P < 0.001) in the 12 eligible studies. The pooled incidence of PTSD in fracture patients was 29% (95% CI, 20% to 39%) using random-effects model. Subgroup analyses revealed that the pooled incidence of PTSD among patients after traumatic fracture was statistically significant differences according to the study design, the study location, tools to assess the symptoms of PTSD, the mean age and injury mechanism (all P < 0.001). Fracture sites, injury mechanism and pain were the main influencing factors of PTSD in fracture patients.Our results highlight the phenomenon that high incidence of PTSD in patients after fracture and they should be followed up regularly and be provided effective interventions. Future efforts to improve and control the main influencing factors of PTSD for this population still needed.
Collapse
Affiliation(s)
- Xue Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Zunyi Medical University, Zunyi, China
| | - Xiahong Li
- Department of Epidemiology and Health Statistics, School of Public Health, Zunyi Medical University, Zunyi, China
| | - Miao Qi
- Department of Epidemiology and Health Statistics, School of Public Health, Zunyi Medical University, Zunyi, China
| | - Xiuli Hu
- Department of Epidemiology and Health Statistics, School of Public Health, Zunyi Medical University, Zunyi, China
| | - Huiping Zhu
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China.,Center for Injury Research and Policy & Center for Pediatric Trauma Research, the Research Institute at Nationwide Children's Hospital, the Ohio State University College of Medicine, Columbus, USA
| | - Xiuquan Shi
- Department of Epidemiology and Health Statistics, School of Public Health, Zunyi Medical University, Zunyi, China.,Center for Injury Research and Policy & Center for Pediatric Trauma Research, the Research Institute at Nationwide Children's Hospital, the Ohio State University College of Medicine, Columbus, USA
| |
Collapse
|
12
|
Staben M, Raiten J, Lane-Fall M, Scott M. Development of an Anesthesiology Disaster Response Plan. Anesthesiol Clin 2021; 39:245-253. [PMID: 34024428 PMCID: PMC8053004 DOI: 10.1016/j.anclin.2021.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Mac Staben
- Department of Anesthesiology and Critical Care, Perelman School of Medicine of the University of Pennsylvania, 3400 Spruce Street, Dulles 6, Philadelphia, PA 19104, USA
| | - Jesse Raiten
- Department of Anesthesiology and Critical Care, Perelman School of Medicine of the University of Pennsylvania, 3400 Spruce Street, Dulles 6, Philadelphia, PA 19104, USA.
| | - Meghan Lane-Fall
- Department of Anesthesiology and Critical Care, Perelman School of Medicine of the University of Pennsylvania, 3400 Spruce Street, Dulles 6, Philadelphia, PA 19104, USA
| | - Michael Scott
- Department of Anesthesiology and Critical Care, Perelman School of Medicine of the University of Pennsylvania, 3400 Spruce Street, Dulles 6, Philadelphia, PA 19104, USA
| |
Collapse
|
13
|
Lantagne D, Lehmann L, Yates T, Gallandat K, Sikder M, Domini M, String G. Lessons learned from conducting six multi-country mixed-methods effectiveness research studies on water, sanitation, and hygiene (WASH) interventions in humanitarian response. BMC Public Health 2021; 21:560. [PMID: 33752646 PMCID: PMC7983375 DOI: 10.1186/s12889-021-10597-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Accepted: 03/09/2021] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Provision of safe water, sanitation, and hygiene (WASH) to affected populations in humanitarian emergencies is necessary for dignity and communicable disease control. Additional evidence on WASH interventions is needed in humanitarian settings. Between 2008 and 2019, we completed six multi-country, mixed-methods effectiveness studies in humanitarian response on six different WASH interventions. In each evaluation, we conducted: key informant interviews; water point observations and water quality testing; household surveys with recipients, including survey and water quality testing; focus group discussions; and/or, secondary data analysis. The research questions were: "What is the effectiveness of [intervention] in reducing the risk of diarrhea/cholera transmission; and, what programmatic factors lead to higher effectiveness?" DISCUSSION In all six multi-country, mixed-methods evaluations, policy-relevant outcomes were obtained. We found, in our individual research results, that: interventions could reduce the risk of disease in humanitarian contexts; this reduction of risk did not always occur, as there were large ranges in effectiveness; and, implementation factors were crucial to intervention effectiveness. When collaboratively reviewing our research process across evaluations, we found strategies for successfully conducting this research included: 1) working with partners to identify and evaluate programs; 2) rapidly obtaining approvals to deploy; and, 3) conducting research methodologies consistently. Personal connections, in-person communication, trust, and experience working together were key factors for success in identifying partners for evaluation. Successes in evaluation deployment occurred with flexibility, patience, commitment of adequate time, and understanding of processes; although we note access and security concerns in insecure contexts precluded deployment. Consistent and robust protocols, flexibility, and a consistent researcher on the ground in each context allowed for methodological consistency and high-quality results. CONCLUSIONS In conclusion, we have found multi-country, mixed-methods results to be one crucial piece of the WASH evidence base in humanitarian contexts. This is particularly because evaluations of reductions in risk from real-world programming are policy-relevant, and are directly used to improve programming. In future, we need to flexibly work with donors, agencies, institutions, responders, local governments, local responders, and beneficiaries to design safe and ethical research protocols to answer questions related to WASH interventions effectiveness in humanitarian response, and, improve WASH programming.
Collapse
Affiliation(s)
| | - Lilian Lehmann
- Innovations for Poverty Action, New Haven, CT, USA
- IDinsight, Manila, Philippines
| | - Travis Yates
- Tufts University School of Engineering, Medford, MA, USA
| | - Karin Gallandat
- Tufts University School of Engineering, Medford, MA, USA
- London School of Hygiene and Tropical Medicine, London, UK
| | - Mustafa Sikder
- Tufts University School of Engineering, Medford, MA, USA
- Johns Hopkins University, Center for Humanitarian Health, Baltimore, MD, USA
| | - Marta Domini
- Tufts University School of Engineering, Medford, MA, USA
- Brescia University, Brescia, Italy
| | | |
Collapse
|
14
|
Carmassi C, Malacarne P, Dell'oste V, Bertelloni CA, Cordone A, Foghi C, Dell'osso L. Post-traumatic stress disorder, burnout and their impact on global functioning in Italian emergency healthcare workers. Minerva Anestesiol 2021; 87:556-566. [PMID: 33432793 DOI: 10.23736/s0375-9393.20.14853-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Post-traumatic stress disorder (PTSD) and burnout are severe and frequent conditions among emergency healthcare workers exposed to repeated work-related traumatic experiences. The aim of the present study was to investigate PTSD, burnout and global functioning in a sample of emergency healthcare workers (HCWs) of a major university hospital in Italy, exploring possible correlations between the two constructs. METHODS The study sample included 137 medical and nursing Emergency Room and Intensive Care Unit staff members of a major University Hospital in Italy (Pisa), all assessed by means of the Trauma and Loss Spectrum - Self Report (TALS-SR), for post-traumatic stress spectrum, the Professional Quality of Life Scale - Revision IV (ProQOL R-IV), for burnout related to work activities, and the Work and Social Adjustment Scale (WSAS), for global functioning. RESULTS Forty-nine subjects reported a full (18, 14.3%) or partial (31, 24.6%) symptomatological DSM-5 PTSD. HCWs with PTSD reported significantly higher burnout scores and global functioning impairment compared to those without PTSD. Mean to good significant correlations emerged between the TALS-SR total and domains scores, the ProQOL subscales and the WSAS scores. CONCLUSIONS This work, conducted before the COVID-19 pandemic, underlines a positive correlation between burnout and post-traumatic stress spectrum symptoms in emergency HCWs, showing the need for a deeper assessment of work-related post-traumatic stress symptoms in such population in order to improve the well-being and to prevent burnout.
Collapse
Affiliation(s)
- Claudia Carmassi
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Paolo Malacarne
- Anesthesia and Intensive Care Unit, Azienda Ospedaliero-Universitaria Pisana (AOUP), Pisa, Italy
| | - Valerio Dell'oste
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy -
| | - Carlo A Bertelloni
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Annalisa Cordone
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Claudia Foghi
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Liliana Dell'osso
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| |
Collapse
|
15
|
PTSD symptoms in healthcare workers facing the three coronavirus outbreaks: What can we expect after the COVID-19 pandemic. Psychiatry Res 2020; 292:113312. [PMID: 32717711 PMCID: PMC7370915 DOI: 10.1016/j.psychres.2020.113312] [Citation(s) in RCA: 355] [Impact Index Per Article: 88.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 07/18/2020] [Accepted: 07/18/2020] [Indexed: 12/13/2022]
Abstract
The COronaVIrus Disease-19 (COVID-19) pandemic has highlighted the critical need to focus on its impact on the mental health of Healthcare Workers (HCWs) involved in the response to this emergency. It has been consistently shown that a high proportion of HCWs is at greater risk for developing Posttraumatic Stress Disorder (PTSD) and Posttraumatic Stress Symptoms (PTSS). The present study systematic reviewed studies conducted in the context of the three major Coronavirus outbreaks of the last two decades to investigate risk and resilience factors for PTSD and PTSS in HCWs. Nineteen studies on the SARS 2003 outbreak, two on the MERS 2012 outbreak and three on the COVID-19 ongoing outbreak were included. Some variables were found to be of particular relevance as risk factors as well as resilience factors, including exposure level, working role, years of work experience, social and work support, job organization, quarantine, age, gender, marital status, and coping styles. It will be critical to account for these factors when planning effective intervention strategies, to enhance the resilience and reduce the risk of adverse mental health outcomes among HCWs facing the current COVID-19 pandemic.
Collapse
|
16
|
Hori A, Takebayashi Y, Tsubokura M, Kim Y. PTSD and bipolar II disorder in Fukushima disaster relief workers after the 2011 nuclear accident. BMJ Case Rep 2020; 13:13/9/e236725. [PMID: 32943446 PMCID: PMC7500185 DOI: 10.1136/bcr-2020-236725] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
The global threat posed by the COVID-19 pandemic has highlighted the need to accurately identify the immediate and long-term postdisaster impacts on disaster-relief workers. We examined the case of a local government employee suffering from post-traumatic stress disorder (PTSD) and bipolar II disorder following the Great East Japan Earthquake. The complex and harsh experience provoked a hypomanic response such as elated feelings with increased energy, decreased need for sleep and an increase in goal-directed activity, which allowed him to continue working, even though he was adversely affected by the disaster. However, 3.5 years later, when he suffered further psychological damage, his PTSD symptoms became evident. In addition to treating mood disorders, trauma-focused psychotherapy was required for his recovery. Thereafter, we considered the characteristics of mental health problems that emerge in disaster-relief workers, a long time after the disaster, and the conditions and treatments necessary for recovery.
Collapse
Affiliation(s)
- Arinobu Hori
- Department of Psychiatry, Hori Mental Clinic, Minami-soma, Fukushima, Japan .,Department of Neuropsychiatry, Fukushima Medical University School of Medicine, Fukushima, Fukushima, Japan
| | - Yoshitake Takebayashi
- Department of Health Risk Communication, Fukushima Medical University School of Medicine, Fukushima, Fukushima, Japan
| | - Masaharu Tsubokura
- Department of Radiation Health Management, Fukushima Medical University School of Medicine, Fukushima, Fukushima, Japan
| | - Yoshiharu Kim
- National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
| |
Collapse
|
17
|
Sommer JL, El-Gabalawy R, Taillieu T, Afifi TO, Carleton RN. Associations between Trauma Exposure and Physical Conditions among Public Safety Personnel: Associations entre l'exposition à un traumatisme et les problèmes physiques chez le personnel de la santé publique. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2020; 65:548-558. [PMID: 32275461 PMCID: PMC7361655 DOI: 10.1177/0706743720919278] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Trauma exposure is associated with adverse health-related correlates, including physical comorbidities, and is highly prevalent among public safety personnel (PSP). The current study (1) examined the association between context of index trauma exposure (part of job vs. other) and physical conditions and (2) established the prevalence of physical conditions according to PSP category (e.g., police, paramedic) and index trauma type (e.g., serious accident, physical assault) in a large Canadian sample of PSP. METHODS PSP completed an online survey between September 2016 and January 2017. Multivariable logistic regressions examined associations between context of index trauma exposure (i.e., part of job vs. other) and physical condition categories. Cross-tabulations with chi-square analyses examined whether the prevalence of physical conditions significantly differed according to PSP category and index trauma type. RESULTS There were 5,267 PSP included in the current study. Results from the most stringent model of logistic regressions demonstrated that, compared to PSP who experienced their index trauma in any other context, PSP who experienced it as part of their job had reduced odds of "other" physical conditions (adjusted odds ratio = 0.73, 95% confidence interval, 0.57 to 0.94, P < 0.05). Results also revealed significant differences in the prevalence of physical conditions across all PSP categories and select index trauma types. CONCLUSION Results highlight the relevance of trauma exposure outside of an occupational context among PSP and may have implications for the positive impact of stress inoculation and resiliency training programs for PSP.
Collapse
Affiliation(s)
- Jordana L. Sommer
- Department of Psychology, University of Manitoba, Winnipeg,
Canada
- Department of Anesthesiology, Perioperative and Pain Medicine,
University of Manitoba, Winnipeg, Canada
| | - Renée El-Gabalawy
- Department of Psychology, University of Manitoba, Winnipeg,
Canada
- Department of Anesthesiology, Perioperative and Pain Medicine,
University of Manitoba, Winnipeg, Canada
- Department of Clinical Health Psychology, University of Manitoba,
Winnipeg, Canada
- Department of Psychiatry, University of Manitoba, Winnipeg,
Canada
| | - Tamara Taillieu
- Department of Community Health Sciences, University of Manitoba,
Winnipeg, Canada
| | - Tracie O. Afifi
- Department of Psychiatry, University of Manitoba, Winnipeg,
Canada
- Department of Community Health Sciences, University of Manitoba,
Winnipeg, Canada
| | | |
Collapse
|
18
|
Capielo Rosario C, Abreu RL, Gonzalez KA, Cardenas Bautista E. “That day no one spoke”: Florida Puerto Ricans’ Reaction to Hurricane María. COUNSELING PSYCHOLOGIST 2020. [DOI: 10.1177/0011000019899382] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
We conducted two focus groups and four individual interviews to examine the experiences of Florida Puerto Rican adults ( N = 26) with secondary exposure to the devastation caused by Hurricane María. Results from our thematic analysis yielded four major themes and eight subthemes depicting responses to Hurricane María. Four major themes emerged across participant responses: 1) Participants’ Experience with Hurricane María, 2) Participants’ Negative Reactions to Hurricane María, 3) Participants Providing Support, and 4) Resilience and Growth. We also found that Florida Puerto Ricans’ secondary stress reactions were influenced by Puerto Rico’s political status and economic crisis. Results also indicated that participants experienced vicarious posttraumatic growth not only at the individual but also at the community level.
Collapse
|
19
|
Abstract
INTRODUCTION Disasters cause severe disruption to socio-economic, infrastructural, and environmental aspects of community and nation. While the impact of disasters is strongly felt by those directly affected, they also have significant impacts on the mental and physical health of relief/recovery workers and volunteers. Variations in the nature and scale of disasters necessitate different approaches to risk management and hazard reduction during the response and recovery phases. METHOD Published articles (2010-2017) on the quantitative and quantitative relationship between disasters and the physical and mental health of relief/recovery workers and volunteers were systematically collected and reviewed. A total of 162 relevant studies were identified. Physical injuries and mental health impacts were categorized into immediate, short-term, and chronic conditions. A systematic review of the literature was undertaken to explore the health risks and injuries encountered by disaster relief workers and volunteers, and to identify the factors contributing to these and relating mitigation strategies. RESULTS There were relatively few studies into this issue. However, the majority of the scrutinized articles highlighted the dependence of nature and scope of injuries with the disaster type and the types of responders, while the living and working environment and socio-economic standing also had significant influence on health outcomes. CONCLUSION A conceptual framework derived from the literature review clearly illustrated several critical elements that directly or indirectly cause damage to physical and mental health of disaster responders. Pre-disaster and post-disaster risk mitigation approaches may be employed to reduce the vulnerability of both volunteers and workers while understanding the identified stressors and their relationships.Khatri KC J, Fitzgerald G, Poudyal Chhetri MB. Health risks in disaster responders: a conceptual framework. Prehosp Disaster Med. 2019;34(2):209-216.
Collapse
|
20
|
Disaster Medicine: A Comprehensive Review of the Literature From 2016. Disaster Med Public Health Prep 2019; 13:946-957. [PMID: 31213210 DOI: 10.1017/dmp.2019.18] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The Society of Academic Emergency Medicine Disaster Medicine Interest Group, the Office of the Assistant Secretary for Preparedness and Response - Technical Resources, Assistance Center, and Information Exchange (ASPR TRACIE) team, and the National Institutes of Health Library searched disaster medicine peer-reviewed and gray literature to identify, review, and disseminate the most important new research in this field for academics and practitioners. METHODS MEDLINE/PubMed and Scopus databases were searched with key words. Additional gray literature and focused hand search were performed. A Level I review of titles and abstracts with inclusion criteria of disaster medicine, health care system, and disaster type concepts was performed. Eight reviewers performed Level II full-text review and formal scoring for overall quality, impact, clarity, and importance, with scoring ranging from 0 to 20. Reviewers summarized and critiqued articles scoring 16.5 and above. RESULTS Articles totaling 1176 were identified, and 347 were screened in a Level II review. Of these, 193 (56%) were Original Research, 117 (34%) Case Report or other, and 37 (11%) were Review/Meta-Analysis. The average final score after a Level II review was 11.34. Eighteen articles scored 16.5 or higher. Of the 18 articles, 9 (50%) were Case Report or other, 7 (39%) were Original Research, and 2 (11%) were Review/Meta-Analysis. CONCLUSIONS This first review highlighted the breadth of disaster medicine, including emerging infectious disease outbreaks, terror attacks, and natural disasters. We hope this review becomes an annual source of actionable, pertinent literature for the emerging field of disaster medicine.
Collapse
|
21
|
Health Risks and Challenges in Earthquake Responders in Nepal: A Qualitative Research. Prehosp Disaster Med 2019; 34:274-281. [PMID: 31204642 DOI: 10.1017/s1049023x19004370] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
INTRODUCTION While the impact of disasters is strongly felt by those directly affected, they also have significant impact on the mental and physical health of rescue/relief workers and volunteers during the response phase of disaster management. METHOD Semi-structured interviews were conducted with 11 experts in the field of disaster management from Nepal, inquiring specifically about the impact of the 2015 mega-earthquake on the mental and physical health of rescue/relief workers and volunteers. A thematic approach was used to analyze the results. These were used to assess the applicability of a previously developed conceptual framework which illustrates the hazards and risk factors affecting disaster response workers and the related hazard mitigation approaches. RESULTS The findings suggested a relationship between the type of injuries to responders and the type of disaster, type of responder, and vulnerability of location. The conceptual framework derived from literature was verified for its applicability with a slight revision on analysis of experts' opinion based on particular context and disaster setting. Technical skills of responders, social stigma, governance, and the socio-economic status of the affected nation were identified as critical influencing factors to heath injuries and could be minimized utilizing some specific or collective measures targeted at the aforementioned variables. Some geographic and weather-specific risks may be challenging to overcome. CONCLUSION To prevent or minimize the hazards for disaster relief workers, it is vital to understand the variables that contribute to injuries. Risk minimization strategies should address these critical factors.
Collapse
|
22
|
Environmental Heat Exposure and Heat-Related Symptoms in United States Coast Guard Deepwater Horizon Disaster Responders. Disaster Med Public Health Prep 2018; 13:561-569. [PMID: 30398128 DOI: 10.1017/dmp.2018.120] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVES The response to the 2010 Deepwater Horizon oil spill was impacted by heat. We evaluated the association between environmental heat exposure and self-reported heat-related symptoms in US Coast Guard Deepwater Horizon disaster responders. METHODS Utilizing climate data and postdeployment survey responses from 3648 responders, we assigned heat exposure categories based on both wet bulb globe temperature (WBGT) and heat index (HI) measurements (median, mean, maximum). We calculated prevalence ratios (PRs) and 95% confidence intervals (CIs) via adjusted Poisson regression models with robust error variance to estimate associations with reported heat-related symptoms. We also evaluated the association between use of personal protective equipment (PPE) and heat-related symptoms. RESULTS Those in the highest WBGT median-based heat exposure category had increased prevalence of heat-related symptoms compared to those in the lowest category (PR=2.22 [95% CI: 1.61, 3.06]), and there was a significant exposure-response trend (P<.001). Results were similar for exposure categories based on WBGT and HI metrics. Analyses stratified by use of PPE found significantly stronger associations between environmental heat exposure and heat-related symptoms in those who did not use PPE (PR=2.23 [95% CI: 1.10, 4.51]) than in those who did (PR=1.64 [95% CI: 1.14, 2.36]). CONCLUSIONS US Coast Guard Deepwater Horizon disaster responders who experienced higher levels of environmental heat had higher prevalences of heat-related symptoms. These symptoms may impact health, safety, and mission effectiveness. As global climate change increases the frequency of disasters and weather extremes, actions must be taken to prevent heat-related health impacts among disaster responders. (Disaster Med Public Health Preparedness. 2019;13:561-569).
Collapse
|
23
|
Prevalence Rates and Correlates of Probable Major Depressive Disorder in Residents of Fort McMurray 6 Months After a Wildfire. Int J Ment Health Addict 2018. [DOI: 10.1007/s11469-018-0004-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
|
24
|
Augusterfer EF, Mollica RF, Lavelle J. Leveraging Technology in Post-Disaster Settings: the Role of Digital Health/Telemental Health. Curr Psychiatry Rep 2018; 20:88. [PMID: 30155744 DOI: 10.1007/s11920-018-0953-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
THE PURPOSE REVIEW This paper will review the literature on global disasters and the mental health impact of disasters, and discuss the use of digital health/telemental health in providing care in post-disaster settings. RECENT FINDINGS Global disasters, natural and manmade, are on the rise. As a consequence, there are increases in the health and mental health impact in the affected populations. We examine the literature on the health and mental health impact of disasters and the role of digital health/telemental health in response to meeting those needs. We examine the use of digital health/telemental health in two case examples, one of a natural disaster and one of a man-made disaster. Finally, we examine a blended telemental health model for collaboration between mental health and primary care providers in post-disaster settings. Digital health/telemental health is positioned on the cusp of the technology explosion, thus bringing much needed medical and mental health care to previously under-served populations.
Collapse
Affiliation(s)
- Eugene F Augusterfer
- Harvard Program in Refugee Trauma, Harvard Global Mental Health Program, 22 Putnam Avenue, Cambridge, MA, 02139, USA.
| | - Richard F Mollica
- Harvard Program in Refugee Trauma, Massachusetts General Hospital, Harvard Medical School, 22 Putnam Avenue, Cambridge, MA, 02139, USA
| | - James Lavelle
- Harvard Program in Refugee Trauma, Harvard Global Mental Health Program, 22 Putnam Avenue, Cambridge, MA, 02139, USA
| |
Collapse
|
25
|
Lee MS, Bhang SY. Assessment Tools for the Mental Health of School-Aged Children and Adolescents Exposed to Disaster: A Systematic Review (1988-2015). Soa Chongsonyon Chongsin Uihak 2018; 29:88-100. [PMID: 32595301 PMCID: PMC7289459 DOI: 10.5765/jkacap.180002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Revised: 04/03/2018] [Accepted: 04/24/2018] [Indexed: 11/05/2022] Open
Abstract
Objectives In this study, we aimed to conduct a systematic review of studies investigating psychosocial factors affecting children exposed to disasters. Methods In total, 140 studies were retrieved. The studies were published from 1988 to 2015. A systematic review was performed using the PRISMA guidelines. MEDLINE, EMBASE, Cochrane Central, Web of Science, PsycINFO, PubMed, and Google Scholar were searched. Each database was searched using the following terms: 'Child,' 'Adolescent,' 'Youth,' 'Disaster,' 'Posttraumatic,' 'Psychosocial,' 'Assessment,' 'Evaluation,' and 'Screening.' The identified studies were subjected to data extraction and appraisal. Results The database search identified 713 articles. Based on the titles and abstracts, the full texts of 118 articles were obtained. The findings of this review can be used as a basis for the design of a psychosocial evaluation tool for disaster preparedness. Conclusion Given the paramount importance of post-disaster evaluation and the weaknesses of current disaster evaluation tools, the need to develop valid and reliable tools and psychometric evaluations cannot be overstated. Our findings provide current evidence supporting various assessments in children, who are very vulnerable psychologically following disasters.
Collapse
Affiliation(s)
- Mi-Sun Lee
- Department of Psychiatry, Eulji University Hospital, Seoul, Korea
| | - Soo-Young Bhang
- Department of Psychiatry, Eulji University School of Medicine, Eulji University Hospital, Seoul, Korea
| |
Collapse
|
26
|
Risks, Health Consequences, and Response Challenges for Small-Island-Based Populations: Observations From the 2017 Atlantic Hurricane Season. Disaster Med Public Health Prep 2018; 13:5-17. [PMID: 29622053 DOI: 10.1017/dmp.2018.28] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
ABSTRACTThe intensely active 2017 Atlantic basin hurricane season provided an opportunity to examine how climate drivers, including warming oceans and rising seas, exacerbated tropical cyclone hazards. The season also highlighted the unique vulnerabilities of populations residing on Small Island Developing States (SIDS) to the catastrophic potential of these storms. During 2017, 22 of the 29 Caribbean SIDS were affected by at least one named storm, and multiple SIDS experienced extreme damage. This paper aims to review the multiplicity of storm impacts on Caribbean SIDS throughout the 2017 season, to explicate the influences of climate drivers on storm formation and intensity, to explore the propensity of SIDS to sustain severe damage and prolonged disruption of essential services, to document the spectrum of public health consequences, and to delineate the daunting hurdles that challenged emergency response and recovery operations for island-based, disaster-affected populations. (Disaster Med Public Health Preparedness. 2019;13:5-17).
Collapse
|
27
|
Nolty AAT, Bosch DS, An E, Clements CT, Buckwalter JG. The Headington Institute Resilience Inventory (HIRI): Development and Validation for Humanitarian Aid Workers. ACTA ACUST UNITED AC 2018. [DOI: 10.1037/ipp0000080] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
We developed the Headington Institute Resilience Inventory as a psychometrically valid, multifactored self-report measure to identify dimensions of resilience for international aid workers. We define resilience as the capacity to adapt during traumatic incidents so that one not only just survives but survives well. By utilizing a dynamic approach to resilience to predict this adaptive capacity, we aim to identify dimensions that could lead to personalized protective training exercises, essential because of the work in areas of constant tension where there is a high risk of exposure to traumatic events. From 84 theory-driven items, through exploratory and confirmatory factor analyses with 2 samples of aid workers ( ns = 724 and 829), we identified and refined the most robust factors. Our resulting 7-factor, 33-item measure had αs greater than .69 for all factors, test–retest reliability coefficients between .79 and .94, and an estimate of composite scale reliability of .82. The findings are congruent with social–cognitive theories of resilience, which provide a plausible understanding of resilience as a multifaceted, dynamic construct. Although continued research is needed to fully validate the construct of resilience, this framework identifies dimensions of protective assets that are believed to be amenable to development, thus providing aid workers with a working definition of resilience.
Collapse
Affiliation(s)
- Anne A. T. Nolty
- Headington Institute, Pasadena, California, and Graduate School of Psychology, Fuller Theological Seminary, Pasadena, California
| | | | - Eric An
- Graduate School of Psychology, Fuller Theological Seminary, Pasadena, California
| | - Crystal T. Clements
- Graduate School of Psychology, Fuller Theological Seminary, Pasadena, California
| | | |
Collapse
|
28
|
Abstract
Introduction Disaster and humanitarian responders are at-risk of experiencing a wide range of physical and psychological health conditions, from minor injuries to chronic mental health problems and fatalities. This article reviews the current literature on the major health outcomes of responders to various disasters and conflicts in order to better inform individuals of the risks and to inform deploying agencies of the health care needs of responders. METHODS In March 2014, an EMBASE search was conducted using pre-defined search criteria. Two reviewers screened the resultant 2,849 abstracts and the 66 full-length manuscripts which are included in the review. RESULTS The majority of research on health outcomes of responders focused on mental health (57 of 66 articles). Posttraumatic stress disorder (PTSD) and depression were the most studied diagnoses with prevalence of PTSD ranging from 0%-34% and depression from 21%-53%. Physical health outcomes were much less well-studied and included a wide range of environmental, infectious, and traumatic conditions such as heat stroke, insect bites, dermatologic, gastrointestinal, and respiratory diseases, as well as burns, fractures, falls, and other traumatic injuries. CONCLUSIONS The prevalence of mental health disorders in responders may vary more and be higher than previously suggested. Overall health outcomes of responders are likely poorly monitored and under-reported. Improved surveillance systems and risk mitigation strategies should be employed in all disaster and conflict responses to better protect individual responders. Garbern SC , Ebbeling LG , Bartels SA . A systematic review of health outcomes among disaster and humanitarian responders. Prehosp Disaster Med. 2016;31(6):635-642.
Collapse
|